keyword
MENU ▼
Read by QxMD icon Read
search

Autonomy residents safety

keyword
https://www.readbyqxmd.com/read/28882683/structured-operative-autonomy-an-institutional-approach-to-enhancing-surgical-resident-education-without-impacting-patient-outcomes
#1
Brandon M Wojcik, Zhi Ven Fong, Madhukar S Patel, David C Chang, Dustin R Long, Haytham Ma Kaafarani, Emil Petrusa, John T Mullen, Keith D Lillemoe, Roy Phitayakorn
BACKGROUND: Though barriers to granting surgical residents autonomy in the operating room are well described, few have proposed practical strategies to overcome them. Our department adopted a multidisciplinary approach to develop a rotation that aimed to grant chief residents structured operative autonomy. In this study, we assess the feasibility of implementation, impact on patient safety and educational benefit to residents following the program's pilot year. STUDY DESIGN: During a one-month rotation, chief residents began cases alone using their own operative block time...
September 4, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28813236/ethics-and-intimate-sexual-activity-in-long-term-care
#2
Eran Metzger
A case is presented in which the staff of a long-term care facility discovers that the husband of a resident with dementia is engaged in sexual activity with her. The case illustrates a dilemma for long-term care facilities that create a home-like environment with a goal of maximizing residents' autonomy while ensuring their safety. An approach to assessing capacity to consent to intimate sexual activity is described, followed by guidelines that nursing homes can implement to support residents who wish to engage in sexual activity...
July 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28742711/readiness-of-us-general-surgery-residents-for-independent-practice
#3
MULTICENTER STUDY
Brian C George, Jordan D Bohnen, Reed G Williams, Shari L Meyerson, Mary C Schuller, Michael J Clark, Andreas H Meier, Laura Torbeck, Samuel P Mandell, John T Mullen, Douglas S Smink, Rebecca E Scully, Jeffrey G Chipman, Edward D Auyang, Kyla P Terhune, Paul E Wise, Jennifer N Choi, Eugene F Foley, Justin B Dimick, Michael A Choti, Nathaniel J Soper, Keith D Lillemoe, Joseph B Zwischenberger, Gary L Dunnington, Debra A DaRosa, Jonathan P Fryer
OBJECTIVE: This study evaluates the current state of the General Surgery (GS) residency training model by investigating resident operative performance and autonomy. BACKGROUND: The American Board of Surgery has designated 132 procedures as being "Core" to the practice of GS. GS residents are expected to be able to safely and independently perform those procedures by the time they graduate. There is growing concern that not all residents achieve that standard. Lack of operative autonomy may play a role...
October 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28652920/perception-of-and-attitude-toward-ethical-issues-among-korean-occupational-physicians
#4
Junghye Choi, Chunhui Suh, Jong-Tae Lee, Segyeong Lee, Chae-Kwan Lee, Gyeong-Jin Lee, Taekjoong Kim, Byung-Chul Son, Jeong-Ho Kim, Kunhyung Kim, Dae Hwan Kim, Ji Young Ryu
BACKGROUND: Occupational physicians (OPs) have complex relationships with employees, employers, and the general public. OPs may have simultaneous obligations towards third parties, which can lead to variable conflicts of interests. Among the various studies of ethical issues related to OPs, few have focused on the Korean OPs. The aim of the present survey was to investigate the ethical contexts, the practical resolutions, and the ethical principles for the Korean OPs. METHODS: An email with a self-administered questionnaire was sent to members of the Korean Society of Occupational and Environmental Medicine, comprising 150 specialists and 130 residents...
2017: Annals of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28452626/swimming-against-the-tide-a-case-study-on-the-removal-of-conservatorship-and-guardianship
#5
Kyle S Page, Kate L M Hinrichs
OBJECTIVE: This article evaluates the role healthcare providers play in balancing safety versus autonomy among elders when performing capacity evaluations. METHODS: Presentation of a case study consisting of an 85-year-old, Caucasian, widowed, male, post-stroke veteran, residing in long-term care. He was assigned a permanent court-appointed joint guardian and conservator, but wanted to remove both of these as he felt he had the ability to manage his own affairs...
January 2017: Clinical Gerontologist
https://www.readbyqxmd.com/read/28423148/increasing-resident-autonomy-without-compromising-patient-safety
#6
Rebecca L Gunter, Jacob A Greenberg
No abstract text is available yet for this article.
July 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28396631/transcranial-electrical-stimulation-to-enhance-cognitive-performance-of-healthy-minors-a-complex-governance-challenge
#7
REVIEW
Jantien W Schuijer, Irja M de Jong, Frank Kupper, Nienke M van Atteveldt
An increasing number of healthy adolescents are consuming products that can enhance their cognitive performance in educational settings. Currently, the use of pharmaceuticals is the most widely discussed enhancement method in the literature, but new evidence suggests that other methods based on Transcranial Electrical Stimulation (tES) also have potential as cognitive enhancer. Just like pharmaceutical enhancers, the availability and education-related use of tES-devices raise a broad range of ethical, legal, and societal issues that need to be addressed by policy-makers...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28349051/implementation-of-a-novel-structured-social-and-wellness-committee-in-a-surgical-residency-program-a-case-study
#8
Kathryn E Van Orden, Stephanie D Talutis, Joanna H Ng-Glazier, Aaron P Richman, Elliot C Pennington, Megan G Janeway, Douglas F Kauffman, Tracey A Dechert
This article provides a theoretical and practical rational for the implementation of an innovative and comprehensive social wellness program in a surgical residency program at a large safety net hospital on the East Coast of the United States. Using basic needs theory, we describe why it is particularly important for surgical residency programs to consider the residents sense of competence, autonomy, and belonging during residence. We describe how we have developed a comprehensive program to address our residents' (and residents' families) psychological needs for competence, autonomy, and belongingness...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28239211/active-subjects-of-passive-monitoring-responses-to-a-passive-monitoring-system-in-low-income-independent-living
#9
Clara Berridge
Passive monitoring technology is beginning to be reimbursed by third-party payers in the United States of America. Given the low voluntary uptake of these technologies on the market, it is important to understand the concerns and perspectives of users, former users and non-users. In this paper, the range of ways older adults relate to passive monitoring in low-income independent-living residences is presented. This includes experiences of adoption, non-adoption, discontinuation and creative 'misuse'. The analysis of interviews reveals three key insights...
March 2017: Ageing and Society
https://www.readbyqxmd.com/read/27886972/the-resident-run-minor-surgery-clinic-a-pilot-study-to-safely-increase-operative-autonomy
#10
REVIEW
Brandon M Wojcik, Zhi Ven Fong, Madhukar S Patel, David C Chang, Emil Petrusa, John T Mullen, Roy Phitayakorn
OBJECTIVE: General surgery training has evolved to align with changes in work hour restrictions, supervision regulations, and reimbursement practices. This has culminated in a lack of operative autonomy, leaving residents feeling inadequately prepared to perform surgery independently when beginning fellowship or practice. A resident-run minor surgery clinic increases junior resident autonomy, but its effects on patient outcomes have not been formally established. This pilot study evaluated the safety of implementing a resident-run minor surgery clinic within a university-based general surgery training program...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27788377/individual-and-contextual-characteristics-of-indoor-and-outdoor-falls-in-older-residents-of-s%C3%A3-o-paulo-brazil
#11
Carla Ferreira do Nascimento, Yeda Aparecida Oliveira Duarte, Maria Lúcia Lebrão, Alexandre Dias Porto Chiavegatto Filho
PURPOSE OF THE STUDY: To analyze a representative sample of older individuals of São Paulo, Brazil, according to outdoor fallers, indoor fallers and non-fallers, and to identify biological and socioeconomic (individual and contextual) factors associated with the occurrence and place of falls. MATERIALS AND METHODS: A cross-sectional study was conducted using data (n = 1345) from the 2010 wave of the Health, Wellbeing and Aging (SABE) Study, a representative sample of older residents (60 years and older) of São Paulo, Brazil...
January 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27768393/care-home-manager-attitudes-to-balancing-risk-and-autonomy-for-residents-with-dementia
#12
Elizabeth A Evans, Elizabeth Perkins, Pam Clarke, Alina Haines, Ashley Baldwin, Richard Whittington
OBJECTIVE: To determine how care home managers negotiate the conflict between maintaining a safe environment while enabling the autonomy of residents with dementia. This is important because there is limited research with care home managers; yet, they are key agents in the implementation of national policies. METHOD: Semi-structured interviews were conducted with 18 managers from care homes offering dementia care in the Northwest of England. Data were analysed using a thematic analysis approach...
October 21, 2016: Aging & Mental Health
https://www.readbyqxmd.com/read/26934694/see-more-do-more-teach-more-surgical-resident-autonomy-and-the-transition-to-independent-practice
#13
Daniel A Hashimoto, William E Bynum, Keith D Lillemoe, Ajit K Sachdeva
The graduate medical education system is tasked with training competent and autonomous health care providers while also improving patient safety, delivering more efficient care, and cutting costs. Concerns about resident autonomy and preparation for independent and safe practice appear to be growing, and the field of surgery faces unique challenges in preparing graduates for independent practice. Multiple factors are contributing to an erosion of resident autonomy and decreased operative experience, including differing views of autonomy, financial forces, duty hours regulations, and diverse community health care needs...
June 2016: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/26692998/progressive-independence-in-clinical-training-perspectives-of-a-national-multispecialty-panel-of-residents-and-fellows
#14
Jeanne M Franzone, Benjamin C Kennedy, HelenMari Merritt, Jessica T Casey, Melissa C Austin, Timothy J Daskivich
BACKGROUND: Progressive independence in patient care activities is imperative for residents' readiness for practice and patient safety of those cared for by graduates of residency programs. However, establishing a standardized system of progressive independence is an ongoing challenge in graduate medical education. OBJECTIVE: We aggregated trainees' perspectives on progressive independence, developed a model of the ideal state, and suggested actionable improvements...
December 2015: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/26691924/young-surgeons-on-speaking-up-when-and-how-surgical-trainees-voice-concerns-about-supervisors-clinical-decisions
#15
Malini D Sur, Nancy Schindler, Puneet Singh, Peter Angelos, Alexander Langerman
BACKGROUND: Poor communication is a known contributor to disasters in aviation and medicine. Crew members are trained to raise concerns about superiors' plans, yet literature exploring surgical trainees' responses to analogous concerns is sparse. METHODS: Surgical residents were interviewed about approaches to concerns about supervisors' clinical decisions using a semistructured guide. Emerging themes were developed using the constant comparative method. RESULTS: Eighteen residents participated...
February 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/26612017/transition-from-training-to-surgical-practice
#16
REVIEW
Thomas H Cogbill, Stephen B Shapiro
Surgical training graduates require a period of adjustment as they transform from trainees to experienced surgeons. Making a smooth transition is important for patient safety and new surgeon success. A subset of current graduates does not feel confident to enter directly into practice. Residency design with curriculum refocus, credentialing to encourage graded responsibility, and increased operative exposure is necessary. Onboarding programs should include formal mentoring, career counseling, proctoring by senior surgeons, and objective review of outcomes...
February 2016: Surgical Clinics of North America
https://www.readbyqxmd.com/read/25730530/model-of-interactive-clinical-supervision-in-acute-care-environments-balancing-patient-care-and-teaching
#17
Dominique Piquette, Carol-Anne Moulton, Vicki R LeBlanc
RATIONALE: Progressive trainee autonomy is considered essential for clinical learning, but potentially harmful for patients. How clinical supervisors and medical trainees establish progressive levels of autonomy in acute care environments without compromising patient safety is largely unknown. OBJECTIVES: To explore how bedside interactions among supervisors and trainees relate to trainee involvement in patient care and to clinical oversight. METHODS: We conducted a qualitative study based on constructivist grounded theory methodology...
April 2015: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/25413914/long-term-culture-change-related-to-rapid-response-system-implementation
#18
Jennifer Stevens, Anna Johansson, Inga Lennes, Douglas Hsu, Anjala Tess, Michael Howell
OBJECTIVES: Increasing attention to patient safety in training hospitals may come at the expense of trainee autonomy and professional growth. This study sought to examine changes in medical trainees' self-reported behaviour after the institution-wide implementation of a rapid response system. METHODS: We conducted a two-point cross-sectional survey of medical trainees in 2006, during the implementation of a rapid response system, and in 2010, in a single academic medical centre...
December 2014: Medical Education
https://www.readbyqxmd.com/read/24818538/perceived-effects-of-the-16-hour-workday-restriction-on-surgical-specialties-quebec-s-experience
#19
COMPARATIVE STUDY
Sébastien Lachance, Jean-François Latulippe, Luc Valiquette, Gaétan Langlois, Yvan Douville, Gerald M Fried, Carole Richard
OBJECTIVE: Quebec was the first Canadian province to implement a 16-hour workday restriction. Our aim was to assess and compare Quebec's surgical residents' and professors' perception regarding the effects on the educational environment, quality of care, and quality of life. DESIGN: The Surgical Theater Educational Environment Measure, the Postgraduate Hospital Educational Environment Measure, quality of the medical act, and quality-of-life questionnaires were administered 6 months after the work-hour restrictions...
September 2014: Journal of Surgical Education
https://www.readbyqxmd.com/read/24362386/the-new-education-frontier-clinical-teaching-at-night
#20
Joshua T Hanson, Read G Pierce, Gurpreet Dhaliwal
Regulations that restrict resident work hours and call for increased resident supervision have increased attending physician presence in the hospital during the nighttime. The resulting increased interactions between attendings and trainees provide an important opportunity and obligation to enhance the quality of learning that takes place in the hospital between 6 PM and 8 AM. Nighttime education should be transformed in a way that maintains clinical productivity for both attending and resident physicians, integrates high-quality teaching and curricula, and achieves a balance between patient safety and resident autonomy...
February 2014: Academic Medicine: Journal of the Association of American Medical Colleges
keyword
keyword
13232
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"